Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701The Effects of Whole Body Vibration on Mobility and Balance in Parkinson Disease: a Systematic Review318326ENShararehSharififarDepartment of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA. Sharareh75@phhp.ufl.eduRogelio A.CoronadoSergioRomeroHassanAzariMaryThigpen2014070120140701Whole body vibration (WBV) is a contemporary treatment modality that holds promise as an exercise training method in health–compromised individuals. A growing number of studies on individuals with Parkinson Disease are examining whether WBV improves balance and functional mobility. However, interpreting WBV studies is challenging since there is variability in the manner in which WBV intervention is conducted. The primary goal of this systematic review was to investigate the effect of WBV on improving mobility and balance as measured by a battery of clinical tests, in patients with Parkinson disease. Studies based on WBV parameters were characterized and a systematic search of peer-reviewed literature in five major databases was conducted. Randomized-controlled trials investigating the effects of WBV in patients with a Parkinson diagnosis and no cognitive impairment were included. A total of six publications met the inclusion criteria. Overall, studies demonstrated mixed results in favor of WBV for improving balance or mobility. The majority of studies seem to suggest a favorable benefit following WBV for mobility and balance, but not when compared to other active intervention or placebo. There was variability in the manner in which WBV intervention was applied. Variations among the six studies included: duration of intervention and rest, follow-up period, type of control groups, frequency of vibration, number of treatment sessions and sex distribution of subjects. Future research is needed to investigate the effects of different types of equipment and treatment dosage in individuals with Parkinson disease.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701The Use of Aloe Vera Extract as a Novel Storage Media for the Avulsed Tooth327332ENSamanehBadakhshDepartment of Pediatric Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran. badakhsh@zums.ac.irTaherehEskandarianTaherehEsmaeilpour2014070120140701Background: Tooth avulsion is one of the most severe dental traumas which most often occur in children. When immediate replantation is not possible, storage in a proper media may lead to a prolonged survival rate. Aloe Vera is a cactus like plant with green, tapered leaves that are filled with a transparent viscous gel. This medicinal plant has significant anti-inflammatory, antioxidant, antibacterial and antifungal effects. The purpose of this study was to assess the effectiveness of different concentrations of Aloe Vera extract compared to DMEM (cell culture medium) and egg white.Methods: The periodontal ligament (PDL) cells were cultured and certain number of cells were treated with Aloe Vera extract (in four different concentrations), egg white and culture media for 1, 3, 6, and 9 hours. Cell viability was determined by using the (3-[4, 5-dimethylthiazolyl-2]-2, 5-diphenyltetrazolium bromide) assay. Moreover, One-way ANOVA and post hoc (LSD) test were used for analyzing the study groups.Results: The results indicate that culture media and Aloe Vera extract (10, 30, and 50% concentration) were statistically similar and significantly preserved more PDL cells compared to other experimental storage media.Conclusion: Aloe Vera 10, 30, and 50% may be recommended as a suitable storage media for avulsed teeth.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Bone Marrow and Karyotype Findings of Patients with Pancytopenia in Southern Iran333340ENAkbarSafaeiDepartment of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Medical_76@yahoo.caMansourehShokripourNavidOmidifar2014070120140701Background: Pancytopenia is a manifestation of a wide range of disorders. The main prognostic factor for predicting outcome and response to treatment is based on the underlying cause. To detect the root cause of this problem, depending on other accompanied signs or symptoms, the need for bone marrow examination and other advanced work ups is different at least at the practical level. This study focuses on the karyotype abnormality and to demonstrate the ability of this complimentary study in diagnosis and prognosis of such patients. Methods: In this cross sectional study, bone marrow aspiration samples of all patients with Pancytopenia underwent cytogenetic investigation on bone marrow aspiration. Gathered data were analyzed by SPSS software. Results: Among the 100 eligible patients, 67% revealed hypercellular, 19% had hypocellular and 13% had normocellular marrow. Most common causes of pancytopenia were myelodysplastic syndrome (MDS) (33%), MDS vs. megaloblastic anemia (23%) and acute leukemia (18%). Thirty one patients had karyotype abnormality in which majority (13 patients) were diagnosed as MDS followed by 11 patients with acute leukemia. Conclusion: Beside bone marrow examination, there is a need for more supplementary studies like karyotyping to detect the exact cause of pancytopenia. It is concluded that cytogenetic study on bone marrow aspiration can be a complementary test in diagnosis of pancytopenic patients. However, there are also cases where diagnosis even with implementing bone marrow examination and cytogenetic analysis is not possible. Such patients require more clinical follow-up and investigation.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Treatment Results and Prognostic Indicators in Thymic Epithelial Tumors: A Clinicopathological Analysis of 45 Patients341349ENMansourAnsariDepartment of Radiation Oncology, Nemazee Teaching Hospital, Shiraz University of Medical Sciences,
Shiraz, Iran. mohpanah@sums.ac.irFarzinDehsaraMohammadMohammadianpanahAhmadMosalaeiShapourOmidvariNiloofarAhmadloo2014070120140701Background: Thymomas are rare epithelial tumors arising from thymus gland. This study aims at investigating the clinical presentation, prognostic factors and treatment outcome of forty five patients with thymoma and thymic carcinoma. Methods: Forty-five patients being histologically diagnosed with thymoma or thymic carcinoma that were treated and followed-up at a tertiary academic hospital during January 1987 and December 2008 were selected for the present study. Twelve patients were solely treated with surgery, 14 with surgery followed by adjuvant radiotherapy, 12 with sequential combined treatment of surgery, radiotherapy and/or chemotherapy and 7 with non-surgical approach including radiotherapy and/or chemotherapy. Tumors were classified based on the new World Health Organization (WHO) histological classification. Results: There were 18 women and 27 men with a median age of 43 years. Twelve patients (26.7%) had stage I, 7 (17.8%) had stage II, 23 (51%) had stage III and 2 (4.5%) had stage IV disease. Tumors types were categorized as type A (n=4), type AB (n=10), type B1 (n=9), type B2 (n=10), type B3 (n=5) and type C (n=7). In univariate analysis for overall survival, disease stage (P=0.001), tumor size (P=0.017) and the extent of surgical resection (P&lt;0.001) were prognostic factors. Regarding the multivariate analysis, only the extent of the surgical resection (P&lt;0.001) was the independent prognostic factor and non-surgical treatment had a negative influence on the survival. The 5-year and 10-year overall survival rates were 70.8% and 62.9%, respectively. Conclusion: Complete surgical resection is the most important prognostic factor in patients with thymic epithelial tumors.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701IL-23/IL-27 Ratio in Peripheral Blood of Patients with Breast Cancer350356ENAliKhodadadiDepartment of Immunology, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran. jaberipm@yahoo.comMahboobehRazmkhahAli-RezaEskandariAhmadHosseiniMojtabaHabibagahiAbbasGhaderiMansoorehJaberipour2014070120140701Background: Interleukin (IL)-23 and IL-27 are two IL-12-related cytokines which their function may dramatically influence the inflammatory response to tumor development. IL-12 and IL-27 seem to have antagonistic roles with IL-23 in tumor site. In this study, IL-23 and IL-27 mRNA expressions were analyzed in peripheral blood of patients with breast cancer and healthy volunteers using quantitative real-time PCR. Methods: Peripheral blood samples were collected from 50 women with breast cancer and 50 healthy ones. The total RNA was extracted from peripheral blood after lysis with ammonium chloride and TRizol reagent and the cDNA was synthesized. The expression of IL-23 and IL-27 gene transcripts was determined with real-time polymerase chain reaction (qRT-PCR) using Syber Green PCR Master Mix. Results: It is found that IL-23 and IL-27 transcripts had significantly higher expression in peripheral blood of patients compared with the healthy controls. The ratio of IL-23 transcript expression to IL-27 was 3.4 fold lower in the studied patients compared with the normal individuals. Conclusion: It is concluded that the over expression of IL-23 and IL-27 gene transcript in peripheral blood of breast cancer patients may be an immune response against tumor development and the inflammatory response plays a critical role in tumor development via up regulating the corresponding cytokines. However, the IL-23/IL-27 ratio may play an important role in cytokine-based immunotherapy against cancer. Further research should be carried out to assess these cytokines in a larger sample size.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Combination Therapy with Losartan and α-Tocopherol in Acute Ureteral Obstruction-Induced Renal Excretory Dysfunction and Acidification Defect357366ENIzadpanahGheitasiDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. mmoosavi@sums.ac.irSeyed MostafaMoosavi2014070120140701Background: Previous study by the authors showed that a-tocopherol prevents oxidative stress but would not improve depressed excretory variables in post-obstructed kidney (POK) after release of 24-h unilateral ureteral obstruction (UUO). This study is a supplementary investigation on the effects of a-tocopherol combined with an antagonist of angiotensin-II type-1 (AT1) receptor on renal dysfunction following release of acute UUO. Methods: The left ureter was ligated in different groups of male Sprague-Dawley rats that received normal saline, losartan or losartan/a-tocopherol (n=6 in each group). After releasing 24-h UUO, urine of each kidney was separately collected under paraffin during 1-3 h of post-release period and then both kidneys were removed for measuring malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP). Results: Losartan-treatment decreased MDA and increased FRAP, creatinine-clearance and sodium-reabsorption in POK, while co-treatment with losartan and a-tocopherol not only augmented improvement in these variables but also elevated potassium-excretion, free-water reabsorption and urine-osmolality. However, UUO-induced fall in urinary pCO2 and rise in pH and bicarbonate-excretion of POK were ameliorated equally with losartan and losartan/a-tocopherol.Conclusion: Activation of AT1-receptor contributes to the development of renal distal acidification defect induced by acute ureteral obstruction. The co-treatment with losartan and a-tocopherol showed that their effects on preventing oxidative stress along with ameliorating glomerular filtration and tubular fluid-delivery in POK could lead to improvement in tubular transport of sodium and potassium as well as urine-concentrating ability at the early post-release period.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Genetic Polymorphisms of CCL22 and CCR4 in Patients with Lung Cancer367373ENNasrollahErfaniShiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. mojtahediz@sums.ac.irAhmadi-SinaNedaei AhmadiMohammad AliGhayumiZahraMojtahedi2014070120140701Background: An association between lung cancer and chemokines has been advocated in the recent years. This study aims at investigating the association between lung cancer and 16C/A single nucleotide polymorphism (SNP) (rs. 4359426) in C-C motif chemokine 22 (CCL22) as well as C1014T SNP (rs. 2228428) in C-C chemokine receptor type 4 (CCR4), which serves as the receptor for CCL22.Methods: Genotyping was performed in 148 lung cancer patients and 148 normal controls using Polymerase Chain Reaction-Restriction-Fragment Length Polymorphism (PCR-RFLP). The data were verified by direct automated sequencing. Results: Frequencies of CC, CA and AA genotypes of 16C/A SNP in CCL22 gene were 112 (75.7%), 33 (22.3%) and 3 (2.0%) in patients, and 119 (80.4%), 24 (16.2%) and 5 (3.4%) in controls respectively. No significant differences were observed in genotype frequencies at this position between cases and controls (P=0.34). Moreover, there was no significant association between CCL22 polymorphism and types of lung cancer in patients. The distribution of CC, CT and TT genotypes of C1014T SNP in CCR4 gene, was 76 (51.4%), 60 (40.5%) and 12 (8.1%) in patients, and 80 (54.1%), 49 (33.1%) and 19 (12.8%) in controls respectively. No statistically significant differences were observed in genotypes frequencies of CCR4 gene between patients and controls (P=0.24). The genotype inherited by patients observed not to be associated with the type of lung cancer (P&gt;0.05).Conclusion: Results reveal that CCL22 gene polymorphism at position 16C/A and CCR4 gene polymorphism at position C1014T, appear not to be associated with susceptibility to lung cancer.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Evaluation of GABA Receptors of Ventral Tegmental Area in Cardiovascular Responses in Rat374381ENMinooRasoulpanahDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. mahatam@sums.ac.irFathmehKharazmiMasoumehHatam2014070120140701Background: The ventral tegmental area (VTA) is well known for its role in cardiovascular control. It is demonstrated that about 20-30% of the VTA neurons are GABAergic though their role in cardiovascular control is not yet understood. This study is carried out to find the effects of GABA A and GABA B receptors on cardiovascular response of the VTA. Methods: Experiments were performed on urethane anesthetized male Wistar rats. Drugs were microinjected unilaterally into the VTA. The average changes in mean arterial pressure (MAP) and heart rate (HR) were compared between the case and the control groups using t test and with the pre-injection values using paired t test.Results: Microinjection of muscimol, a GABAA agonist (500, 1500 and 2500 pmol/100nl) into the VTA had no significant effect on MAP and HR compared with the saline group and pre-injection values. Injection of bicuculline methiodide (BMI, 100 and 200 pmol/100 nl), a GABAA antagonist, caused a significant increase in the MAP (11.1±1.95mmHg, P&lt;0.5) and a decrease in HR (-32.07±10.2, P&lt;0.01). Microinjection of baclofen a GABAB receptor agonist (500 or 1000 pmole/100 nl) and phaclofen a GABAB receptor antagonist (500 or 1000 pmole/100 nl) had no significant effects on MAP and HR.Conclusion: For the first time it was demonstrated that GABA system of the VTA inhibits the cardiovascular system through the activation of GABAA but not the GABAB receptors.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701The Role of Serum Level of Interleukin-6 in Severity of Pulmonary Complications of Sulfur Mustard Injuries382386ENMajidShohratiChemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. mghaneister@gmail.comAliAmini-HarandiBitaNajafianAminSaburiMostafaGhanei2014070120140701Diverse studies suggest that interleukin-6 (IL6), as a member of cytokines family, has a major role in inflammatory processes of airways and lungs. In this study, an attempt was made to determine the serum level of IL6 in sulfur mustard (SM) injured patients and its comparison with controls. The measured IL6 mean level in patients with chemical injuries (0.76±0.3 ng/ml) was significantly higher than the control group’s mean level (0.34±0.12 ng/ml). Furthermore, patients with moderate to severe symptoms had a serum level of (0.95±0.92 ng/ml) which was significantly higher than mild (0.47±0.54) and control (0.34±0.12) groups.The outcome of this research program demonstrates that an increase in serum level of IL6 can have a role in pulmonary complications of SM, similar to other well defined pulmonary diseases. However, further studies are required to clarify the role and mechanism of IL6 in such patients. Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Stereological Estimation of Granule Cell Number and Purkinje Cell Volume in the Cerebellum of Noise-Exposed Young Rat387390ENMohammadHosseini-SharifabadDepartment of Biology and Anatomical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. m_hosseini@ssu.ac.irAbdorezaSabahi2014070120140701In spite of the existing reports on behavioural and biochemical changes related to the cerebellum due to noise stress, not much is known about the effect of noise stress on the neuronal changes in the cerebellum. The present study aims at investigating the effects from one week noise exposure on granule cell number and Purkinje cell volume within the neonate rat cerebellum.15-day-old male Wistar rats were randomly divided into noise exposed (NE) and control groups (n=8 in each group). NE rats exposed to loud noise (100 dB/30 min/3 times per day) during the third postnatal week. One cerebellar half was selected at random for estimating the volume of the cerebellar layers and neuronal quantifications and the other was used for estimating individual somal volume of Purkinje cells. Cavalieri’s principle, physical disector and nucleator methods were employed respectively for unbiased estimation of the volumes of the cerebellar layers, the numerical density of neurons and the individual volume of Purkinje cells.Results of this study show that noise stress significantly decreases the volume of granule layer together with decreased numerical density and total number of granule cells in the cerebellum. Furthermore, a decrease in somal volume of Purkinje cells was found in NE rats. These results, for the first time, demonstrate an effect of noise stress on the granule cell number and individual volume of Purkinje cells in rat cerebellum.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Marfan Syndrome in an Iranian Family: A Case Series391394ENMohammad HosseinDavariBirjand Atherosclerosis and Coronary Artery Research Centre, Birjand University of Medical Sciences,
Birjand, Iran. drtooba.kazemi@gmail.comTobaKazemi2014070120140701Marfan syndrome (MFS) is a genetic disorder which is inherited by autosomal dominant traits. In MFS, lens displacement and cardiovascular involvement are important causes of morbidity and mortality in the clinical course of the disease. In this case study, the ocular involvement in a family with severe penetration of MFS is reported. Twelve members of a family (father, two daughters, three sons, and six grandchildren) had MFS. Lens ectopia was the most common ophthalmic involvement among the family (100%). Other ocular involvements were as follows; Hypoplastic iris or ciliary’s muscle hypoplasia (50%), on gated eyeball (42%), flat cornea (30%), glaucoma and cataract (25%), retinal detachment (16%). Three members of the family underwent eye surgery including lens extraction, glaucoma surgery and retinal surgery.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Pulmonary Embolism with Abdominal Pain and ST Elevation: A Case Report395398ENMohammad JavadFallahiPulmonary and Critical Care Division, Department of Internal Medicine, Nemazee Teaching Hospital,
Shiraz University of Medical Sciences, Shiraz, Iran. masoomm@sums.ac.irSeyed MasoomMasoompourMehdiMirzaee2014070120140701Pulmonary embolism is considered as a great masquerader due to its frequent nonspecific signs and symptoms. Typically pulmonary embolism is under-diagnosed or over-diagnosed. In this study a patient with pulmonary embolism is reported in which the patient exhibited two unusual manifestations namely; right upper quadrant abdominal pain and ST-T elevation in anterior precordial leads. Due to the fact that the patient did not display typical pulmonary embolism symptoms and its major risk factors, extensive workup to discern the cause was carried out. The examination included abdominal sonography, kidney ureter and bladder Computed Tomography scan (CT-scan) and coronary angiography. Eventually after a six-day delay, pulmonary embolism was diagnosed by spiral chest CT scan. This case and several other similar reports underlines the fact that while various other common causes may exist for right upper abdominal pain, one should always consider pulmonary embolism as a possible cause especially when backed up with ECG finding.Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639420140701Causes of Mortality during the First Five Years of Life, Yazd City, Iran (2005-2008)399400ENMohammad RezaVafaeenasabCardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. n479g@ssu.ac.irNasrinGhasemiSamanehMahmoodiFatemehGhasemi2014070120140701